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This week, I was reminded of a time in the past when I worked on a leadership team that did not function as well as it could have. We were a diverse group of people from many different backgrounds with a wide array of professional expertise. Individually, we were all really good at what we did, and we all accomplished a lot within the departments we directed. As a leadership team, we even had a pretty clear idea of what our individual responsibilities were; however, we did not work well together to accomplish our shared goal.

We all knew what we were working toward, but we became frustrated when we did not progress quickly enough to the end result. So, we each started doing our own thing, according to our own leadership styles. Pretty soon, everyone was confused because there was so much duplicative work. No one seemed to know what the other was doing, and as a consequence, teams across the organization didn’t know what they needed to do to contribute to the goal or who was supposed to be doing what. I knew in my heart that the employees’ frustration was justified. So, I made a decision—I could allow this lack of coordination to continue, or I could try reshaping the team so that we worked together more effectively. I decided to do the latter.

As the team worked hard to come to an agreement, we conducted an exercise that involved completing a questionnaire to help identify our preferred working styles. It also honed in on how we each responded to stress in the workplace. Many of you have probably taken similar questionnaires, and you were categorized as a combination of letters or a certain color, like yellow, blue, green or red, which defined how you normally acted, as well as how you acted under stress. For example, if you were categorized as yellow, it meant you were generally process driven—a sequential thinker. If you were categorized as blue, it meant you were a “people person” who generally tried to understand everyone’s point of view and tried to get people to work together. Green meant you were a planner and strategist who was easily bored with details. If you were red, you were a detail-oriented person.

When our team shared their predominant color for our normal work mode, we had a great blend of the colors—something all teams should have. We had a people person, a planner, the process-oriented person, and detail-oriented team members. But what happened when we were under stress was really interesting. We were all in the red category. This meant that under stress, we all approached our work from the same point of view, and we didn’t have the important input from the sequential thinkers, the planners or the outgoing people with strong communication skills.

To really emphasize to our group how the organization was affected when this happened, I put tape on the floor so that we had four clear quadrants. I then asked everyone to stand in their respective color quadrant, exactly as the survey tool had placed us in “normal mode”. The closer someone was to the center, the more they reflected traits from multiple quadrants; the further away one was, the more strongly they reflected a single working style.

Under normal circumstances, we were all pretty well distribute across the colors. But when I asked everyone to occupy their stress quadrant in the exact placement the survey depicted, the result explained everything—we were all deep into the red, trying to occupy each other’s space. No wonder the employees said they were confused! In stress mode, our leadership team each tried to take charge, and to the organization, this seemed as if no one was in charge.

Why do I tell you think story? If we are going to achieve Best Care, we need everyone in the organization to contribute their unique talents and working styles to the team. Whether you are mostly a planner, a people person, a strategist or an operational process person, we need all of you contributing to reaching Best Care by August 31, 2017.

So what can you do?

Make sure that you understand your primary role on the team – whether you are on a patient care team or an operational team. Your position description provides guidance on your job, but what is your role on the care team? If you are not sure, your manager or leader should help you better understand your role and the contribution you can make to Best Care.

If you are a manager or leader, your job is to have clarity about how your area can most effectively contribute to Best Care, and then make sure that everyone knows they are on the team and what their role should be.

It is so important that we try to stay in our “normal” mode at work, because if we are operating under stress, we may not be able to contribute to our teams in a positive way, or we may create a situation where our environment could potentially become unsafe. Dr. Gary Grody defined stress this way: “Stress is defined as an inability, or the perception that you are unable, to take control of your life. If you feel in control, even if you’re not but you perceive you are, you won’t feel the stress.”

We all have high hopes for what UTMB Health can achieve over the next year as we work toward our goal of Best Care. We are already beginning to emerge as a leading academic medical center in many ways—we have experienced unprecedented growth and are performing better than most in many areas. Now, to deliver the Best Careto every patients, every time, we must remain focused on what we want to happen as an organization.

We will be rapidly moving toward our goal, so let’s remember to continue working together steadily as a team toward the goal, even in the face of challenges or frustration. Zig Ziglar says, “When obstacles arise, you change your direction to reach your goal; you do not change your decision to get there.” We must identify the areas in which we can make a change and come up with creative solutions to move the needle. We have an opportunity to become a model healthcare organization, and teamwork, focus and effective communication will be critical to improving the health and well being of all we serve!

On Wednesday, I had the pleasure of speaking at a Lunch & Learn for Health System leadership about the importance of accountability for both individuals and members of leadership. I am sharing it today via the Health System Intranet for you to review. Whether you are a manager, director or individual staff member, there are worthwhile reminders in the presentation for all of us.

After the presentation, I began thinking about how important the principle of accountability will be to achieving our goal of Best Care this year. You will recall that Best Care is an initiative we are implementing in response to University of Texas System Chancellor William McRaven’s challenge that UTMB rank in the top 20 of academic medical centers by August 31, 2017 (as measured by the Vizient* Quality & Accountability Study).

In Stephen Covey’s book “The 4 Disciplines of Execution,” he contrasts an organization that thinks conventionally with one that thinks in terms of both individual and collective accountability. In the organization with conventional thinking, team accountability is always top down: “We meet with the boss periodically and s/he lets us know how we’re doing and what we should focus on next.” In the organization used for contrast, the individuals on the team collectively share accountability for achieving goals and results: “We make commitments and then we’re accountable to the boss; but more importantly, we are accountable to each other for following through.”

A culture of accountability is crucial to achieving goals, particularly when the storms of change and multiple priorities are whirling around us. Often in these types of environments, teams end up breaking apart because individuals decide to go off on their own to “just get it done”. The goal becomes increasingly difficult to achieve if, within the whirlwind, we are also trying to change the behaviors of a lot of people.

With this in mind, I started thinking about how much we have going on right now. We are really going to need to buckle down, prioritize our work, and maintain a steadfast focus on achieving Best Care, especially because reaching this goal will require changing the behaviors of many people and teams. Failure to achieve Best Care is not an option, because it is the right thing to do for our patients!

The work that we must do to deliver on our promise of Best Care reminds me of the book, “Into Thin Air,” which tells the story of two teams of climbers who attempted to get to the summit of Mount Everest. The first team included the author of the book, Jon Krakauer. He wrote about the numerous adversities his team encountered as they tried to reach the summit. As blizzards, high winds and altitude sickness began to affect the team, certain members decided to split off on their own in an attempt to get to the top. Although each climber had the same goal, by setting out on their own, they abandoned the team and discarded discipline and accountability to each other. The results were disastrous as the weather conditions proved too much for eight of the climbers who ultimately lost their lives.

The second team of climbers included a blind climber, Erik Weihenmayer. If the group succeeded, Erik would become the first blind person to reach the top of Mt. Everest. The biggest difference between this group and first is that at the end of each day, they huddled together in what they called a “tent meeting” to talk about what they had accomplished and what they had learned. The team used the meetings to review their strategy, make needed adjustments in their approach to the climb, and define each member’s role. They also decided who on the team would go ahead to clear the path and secure the ropes so that Erik could climb.

Erik characterized the teamwork this way: “Our team stuck together and took care of each other, which gave me the courage to finish.” The result? On May 25, 2001, the team reached their goal, and Erik Weihenmayer became the first blind person to stand on the summit of Mt. Everest.

There are so many lessons to be learned from this story, but here are some of the critical ones that we will need to implement to ensure we achieve Best Care:

Form teams that have specific goals for achieving Best Care.

Make certain that the team has their specific goal, target and deadline assigned and understood.

Encourage the team to engage in developing the plan to achieve the goal.

Make sure that everyone on the team understands their role, including the role of the leader.

Hold each other accountable for making contributions to the team. Speak up in a kind and understanding way to help a team member who is not fulfilling their role on the team—encourage them, but also be firm about the fact that everyone on the team has to do their part in order to deliver Best Care to every patient, every time.

Meet regularly and make adjustments along the way.

Celebrate milestones and congratulate individuals who demonstrate exceptional effort along the way.

Most importantly, ensure that the patient and their loved ones are at the center of all decisions. This is not about “us” or “me”. It is about doing what is best and right for the patient.

Accountability is critical to any organization’s success. Even if we have all the goals, priorities and metrics set, without accountable leaders, teams and individuals, we cannot achieve our goal. If we commit to these actions, on August 31, 2017, we will have achieved our goal of Best Care.

As we approach the end of Nurses’ Week & Health System Week, I want to remind each of you of how important you are to UTMB Health. Our success as a healthcare provider depends on the positive interactions you have each day with our patients and visitors, your willingness to do what is in the best interest of the patient, and your unrelenting quest to deliver the best care to our patients.

Last week, I had a firsthand opportunity to witness the wonders you work every day when one of my family members became a patient. The week became one of comparison and contrast. Our experience started out at another hospital about an hour away. Without going into the details of that experience, I will say that there was a point where my family member wondered out loud if the nurses, technicians, doctors and other staff even cared about the people who were there to receive care.

I asked my family member why they felt that way, and I wholeheartedly agreed with their response. In a waiting room jammed with people, there was no communication. Staff sat around and visited or looked at their phones and never communicated with the patients who were waiting to be seen. It took almost six hours to get to the exam room from the waiting room. During that time, the only communication we had with anyone was when someone from our family actively went up to the desk to ask when we might be seen. Each time the answer was the same: “I have no idea. It’s busy tonight.” It was true—the place was so busy, patients were being placed in rooms that had not even been cleaned. In short, it truly seemed like no one cared about the patients or even cared about their job.

The next morning, we chose to come to UTMB, and in contrast, my family member’s experience was light-years apart from the experience of the night before. After we got the patient settled into the room, several nurses, physicians and residents came into the room to get things started. My family member commented to me that they were so relieved to be at UTMB: “It is obvious that they really care about their patients. I always feel well cared for and safe when I am here.”

Naturally, I could not help but wonder if the fact that my name was “Sollenberger” was part of the reason for this service, but as I watched other patients in the area, what I witnessed makes me feel certain that the staff members here treat all patients alike—with respect, compassion and concern for their privacy and safety.

To me, it is odd that a patient would even have to be concerned about whether or not other people are eavesdropping in on what they are telling their caregivers. It is odd to me that a patient would ever have to worry about their safety while in the hospital. It is concerning to me that a patient should have to be concerned about acquiring an infection from dirty rooms, soiled linens, or from people entering their room without washing their hands. It is concerning to me that a patient would have to worry about whether or not they have a voice in their care.

At the other hospital, all of these concerns were valid. At UTMB, they were not. At UTMB, each person treated our patient with the utmost courtesy and attention. Each person who came in contact with our patient followed the proper protocols for patient identification, each person performed hand hygiene, and each person explained in detail what to expect and asked if the patient had any questions. Each interaction with a nurse or physician made it clear that we were at the center of their work and decision-making. As support staff interacted with the patient—whether when cleaning the room, transporting the patient, or delivering meals—it was clear that they genuinely cared about the patient and took their role in the care process very seriously.

Fortunately, we were able to leave the hospital last Friday. We are so relieved that our family member is on the mend. However, we simply cannot forget the feeling of care and compassion that each person with whom we interacted demonstrated as they went about doing an exceptional job. What will not leave us is the sense of confidence we had in the total care experience. It simply was the BEST!

So, to every person who cares for or interacts with our patients, THANK YOU! Thank you for blending compassion with your care. Thank you for showing respect for the patient, regardless of circumstances. Thank you for stopping to listen, even when you are busy beyond belief. But most of all, thank you for treating your work at UTMB as more than a job or a paycheck. You are setting the bar high for all healthcare professionals in the Greater Houston area. You are making UTMB known as a place where everyone truly works together to work wonders.

HAPPY HEALTH SYSTEM WEEK! HAPPY NURSES’ WEEK! And because I cannot say it enough, thank you!

Last Friday, before the formal Jennie Sealy Dedication Ceremony, I had the opportunity to join Dr. Callender, Dr. Jacobs and Ms. Sadro in welcoming to a luncheon the many dignitaries and benefactors who joined us on the Galveston campus. From state representatives to current and former University of Texas System Chancellors, from members of the UT System Board of Regents members to the Sealy & Smith Foundation Board and the Moody Foundation Board, a large and distinguished group of individuals joined in the day’s celebrations.

That momentous day, as I spoke in front of the group and recounted to them our journey, I felt a tremendous sense of pride in our people. So many of you have stood by UTMB throughout its recovery, renewal and growth after Hurricane Ike. I shared in the great feelings success we all feel about opening the doors of our beautiful new hospital to our patients and their guests on April 9. The Jennie Sealy Hospital represents the effort of so many people who put in thousands of hours of work, developing plans and working to garner the necessary support to begin construction.

It was a year and a day before I began working at UTMB that Hurricane Ike made landfall on Galveston Island. I remember watching the evening news before the storm struck. The forecast was grim. Just before midnight on Friday, September 12, 2008, I received a message from Dr. David Marshall, who was my friend and UTMB’s Chief Operating Officer at the time.

“I am headed to bed for the night. Pray for us.”

I went to bed that night with David’s message on my mind. I thought about the day prior, when UTMB staff had safely evacuated its patients – 471 patients to be exact. Then, they worked to secure the campus, even as storm surge approached. By the time I received David’s message, essential staff were waiting to ride out the storm. Hurricane Ike’s arrival was only hours away.

At 2 a.m., September 13, the eye of the storm passed over UTMB. Although Ike was considered only a Category 2 storm, its size made it one of the most devastating hurricanes in recent U.S. history (it was 70% larger than an average hurricane). In the days that followed, I watched the news with grave concern. Aerial footage showed places on Galveston Island where flood waters had reached nearly 20 feet. Interstate 45 was littered by boats. Homes had been washed entirely off their foundation. I couldn’t believe the magnitude of the devastation.

Town Hall Meeting, October 7, 2008

Nearly a month later, on October 7, I watched a video posted to UTMB’s website of Dr. Callender’s first Town Hall meeting after the storm. He calmly reassured the community that UTMB would be rebuilt, and it would emerge stronger than before. I am certain, at the time, people appreciated the words but had some doubts about whether or not this would truly happen. By then, people across the state were already seriously questioning whether or not UTMB should be rebuilt on the island.

But despite the storm’s damage and all of the naysayers who said UTMB should be closed forever, UTMB’s employees and students courageously marched on, wearing a smile as they helped clean up the campus. The old motto from the Great Storm of 1900 was adopted and prevailed: “UTMB stops for no storm.”

Hurricane Ike Commemoration, September 13, 2009 – Flag Raising

My first day as an employee at UTMB, I remember standing in the grassy area between John Sealy Hospital and the Administration Building to watch the UTMB flag being raised during the Hurricane Ike Commemoration Ceremony. It was an emotional and triumphant day for all of the brave and tenacious students, employees, and faculty who remained so passionately dedicated to rebuilding UTMB on Galveston Island.

John Sealy Hospital had been reopened only nine months ago at the time. One day at noon, I visited the MICU. The area was bustling with activity, and a nurse hurried out of the break room, chewing her last bite of lunch. I said to her, “You all are really busy today.”

Her response was not what I expected: “Yes, isn’t it wonderful that we have our patients back?”

Meanwhile, the pharmacy was still functioning but now out of a patient unit. The usual technology to support its work was absent—there was no robot, no medication carousel, nothing. Just determined pharmacists and technicians who filled hundreds of prescriptions a day with the same degree of accuracy as they had before. The kitchen still occupied a large tent on the top level of the Plaza Garage. Surgical instruments took a 120-mile round trip ride to Sugar Land each day to be sterilized.

Despite these challenges, everyone continued forward with hope and faith, and UTMB quickly moved from recovery into a new era, focused on progress and growth. Here we are today, four years after breaking ground on this hospital. Standing in Jennie Sealy Hospital feels nothing short of a miracle!

I also told these tremendous supporters of UTMB that we had designed our new hospital, first and foremost, with the patient in mind. We had involved nurses, physicians and staff in every step of the design process to ensure the facility would support patient care delivery. We involved students, residents and program leaders in our plans to assure the building would adequately support UTMB’s educational mission, and we identified space to support clinical research.

I told them about how much we had benefited by engaging our patients and the community in the design process. Their feedback added to—and even sometimes challenged—what we had envisioned from an administrative perspective. I told them about the separate zones in the patient rooms for clinical staff, the patient and their family, as well as the wonderful amenities we included thanks to their suggestions, like the specific model of sofa bed and a small refrigerator.

Jennie Sealy Hospital – Community Open House, February 27, 2016

While Jennie Sealy Hospital is UTMB’s gift to the community, it would not have been possible without so many people who stepped forward to help. Students traveled to Austin to talk with legislators about UTMB’s importance. Our staff, alumni and community members advocated for UTMB at public hearings. Our elected officials listened to and championed our cause. The UT System believed in the importance of UTMB’s role in patient care and educating medical professionals in the state. So many people contributed to UTMB’s renewal and growth.

It was an honor to formally thank the Sealy & Smith Foundation, who made an extraordinary and visionary lead gift, signaling to the State of Texas their strong commitment to rebuilding UTMB and assuring excellent care on Galveston Island. It was an honor to thank the Moody Foundation, who are dedicated to supporting our work in managing complex patients and assuring that we have state-of-the-art facilities, equipment and programs to support that care.

I would be remiss if I did not also acknowledge the contributions so many of you, UTMB’s own employees and faculty, who together donated over $11 million to UTMB’s Family Campaign. Your contributions represent how passionately you care about and believe in UTMB. These combined contributions will help thousands of patients and families for many years to come.

There is a quote that I believe captures the essence of what each of you has helped UTMB accomplish:

“It’s impossible,” said pride.

“It’s risky,” said experience.

“It’s pointless,” said reason.

“Give it a try,” whispered the heart.

Thanks to each one of you here today who listened to the whispers of your heart.

During a visit to the NASA space center in 1962, President Kennedy noticed a janitor carrying a broom. He interrupted his tour, walked over to the man and said, “Hi, I’m Jack Kennedy. What are you doing?”

The janitor responded, “I’m helping put a man on the moon, Mr. President.”

I love this story! Obviously, the janitor understood the importance of his contribution. He truly felt he was a valuable part of something bigger than himself, and his attitude created a feeling of self-confidence in his mission. He wasn’t merely a janitor; he was a member of the 1962 NASA Space Team!

Next Saturday, February 13, the Health System will conduct the Mock Patient Move to Jennie Sealy Hospital. Patient care teams have been meticulously rehearsing the details of each patient move, and on that day, with the help of volunteers who will act in the role of “patients”, care teams will rehearse the actual patient move that will occur on April 9. Meanwhile, since the hospital reached substantial completion last month, teams from nearly every department across the organization have played a key role in preparing the hospital to receive its first patients.

In addition to the individuals who are tasked with specific jobs to help prepare the hospital and work through the steps of the patient move, the enthusiasm of everyone across the organization, from staff to physicians to students, is palpable. Everyone wants to help take part in the mock move rehearsals, dedication events and opening day!

The new hospital is beautiful, and in many ways, the significance of its opening parallels putting a man on the moon, because of the incredible teamwork, time, dedication and effort of so many people who have truly worked together to work wonders. It is something we have awaited with great anticipation, and the moment is nearly here.

No matter how large or small your role, whether you are an employee, a student, a clinician or researcher, a donor or a community member, you are contributing to the larger story of UTMB’s history, its resilience, its future, and its important role in the Houston-Galveston region. Together, we are making tomorrow’s history today!

On Monday, January 18, I received a message from Mike Shriner, Vice President of Business Operations and Facilities, confirming that the Jennie Sealy Hospital had reached substantial completion. He also confirmed that all of the life safety and mechanical systems had been tested and passed inspection. Substantial completion is a big deal in a construction project, because it is the day that responsibility for the building changes from being that of the contractor to that of the owner. Jennie Sealy Hospital is now officially UTMB’s! I breathed a sigh of relief when I received this text, because it means we are in the home stretch to opening the building for our patients and their families.

Jennie Sealy Hospital Groundbreaking Ceremony, April 20, 2012

On Wednesday, I had the opportunity to tour the new facility with the Board of Directors of The Sealy & Smith Foundation, who generously contributed $170 million toward the construction of the new hospital. A little less than four years ago, on April 20, 2012, we broke ground on the new hospital together, so it was quite an experience for all of us to finally be inside of the building. Although access to the hospital is still restricted and the building is not open to staff for tours until February 25, I can share that it is a very exciting experience to finally stand inside UTMB’s beautiful new hospital, and the reality that we will soon be welcoming our first patients on April 9, 2016 has really set in!

The day of our tour, the building was teeming with activity. One of the first things I observed were workmen who were going through the punch lists. Punch lists are documents that list small (and sometimes a little bigger) corrections or repairs that need to be made before the building can be occupied. Seeing this activity reminded me of the time my family built our home in Wisconsin. Before we moved in, we walked through the house and used blue tape to mark areas where additional work was needed—on walls, doors and tiles, we had blue tape everywhere from floor to ceiling! We were so excited about finally moving into our new home.

Other workmen throughout the hospital were busy hanging artwork. We developed a small committee to choose the art, and we spent hours doing so. When we chose the different pieces, we made our selections with patients and visitors in mind. Our goal was to create a welcoming environment by providing a connection to nature. Because the hospital is located on Galveston Island, we chose a coastal theme. When you see the art, you will recognize that many of the images depict scenery around the island; in fact, 20% of the collection was purchased from local artists.

As a lover of art and as someone married to an artist, I appreciate how much art can define a space and give it a sense of character. Much of the art selection process was conducted online, so when I finally had the chance to see everything we had selected hung on the wall, I was amazed by how it transformed the space. I was struck by how the pieces were so beautifully illuminated by the natural light in the foyer, creating a very calm and relaxing atmosphere. I definitely have some favorite pieces, and I’m so excited for you all to see them, too. I will be interested to know what your favorites are when you have the chance to tour the hospital.

Throughout the tour, I was very impressed with the new workspaces and how well they are designed to support the work we do. Between every two patient rooms, there is a work area that gives clinicians a direct line of sight to the patient. Each unit also has an employee break room, and there are spaces on each floor for teaching rounds or small meetings. Each patient room has a space for the care team to work and access a computer. There is also an area for the family members to sit and, if they wish, use a laptop or do work on the sofa. If a family member or friend would like to stay overnight in the room with the patient, the sofa turns into a twin-sized bed, and there is a small television in the visitor alcove that allows them to watch television without disturbing the patient.

I must admit, however, that the best part of the hospital is the breathtaking view of the Gulf of Mexico from the patient rooms. I am convinced that these views alone will provide a sense of calm that will contribute positively to the experience of patients and their families and will help the healing process.

I am so excited for our patients, visitors and you to see and work in this space. I arrived at UTMB one year after Hurricane Ike, and I know so many of you were here before, during and after the storm. You all helped make it possible for UTMB to rebound and become the incredible organization it is. As I look at the new Jennie Sealy Hospital, I recall so many of the stories I heard about the struggle to get the support to rebuild UTMB on the island. I recall stories of people who told UTMB President Dr. David Callender that it would not be possible to rebuild the campus and that UTMB should be closed.

Despite the challenges faced, UTMB’s importance to the state was recognized and it was decided that the Galveston campus would be rebuilt. In July 2009, the UTMB community and its supporters watched the historic moment when Texas Governor Rick Perry signed House Bill 4586, the supplemental appropriations bill that included $150 million in funding to help the University of Texas Medical Branch at Galveston recover from Hurricane Ike.

As I look out my office window at the Jennie Sealy Hospital today, I am reminded that this hospital is a symbol of the resilience, tenacity and hard work of so many people at UTMB, of the Galveston community, and many individuals across the State of Texas who never gave up on UTMB Health. Thank you to everyone who has worked so hard to create the new Jennie Sealy Hospital. It will be an honor to care for our patients and their families in this beautiful new facility.

The New Jennie Sealy Hospital – Opening April 9, 2016

Employee Tours of the new Jennie Sealy Hospital will be held Thursday, February 25, 2016 from 4:30 p.m. to 8:30 p.m. More information on the opportunity to tour will be available to you in the next few weeks.

Quite a few years ago, my university alma mater asked me to speak on the topic of leadership and how, throughout the course of my career, I had honed my leadership skills. I began my presentation with an experience I had as a nine-year-old. Sharing this story that evening was especially significant because the main characters of the story, my brother and sister, were both sitting in the audience.

Growing up, my family lived in Paris, Illinois, which is a fairly small town in the central part of the state. There weren’t many organized activities for children, and my mother was often busy caring for my younger siblings, so I learned to keep myself entertained. This particular year, I had resourcefully used my time to orchestrate an illustrious plan—my sister, brother and I would put on a holiday variety show for my parents and grandparents. It would debut the evening of December 24.

I excitedly began production, armed with a hand crank Singer sewing machine and lots of crepe paper. I created costumes for my sister, brother and myself. Then, with a little construction paper and poster board, I built the scenery backdrop. I handcrafted the programs, wrote the script, selected songs we each would sing, and choreographed a dance number for the three of us to perform. I even made special invitations, which I mailed to my grandparents and hand-delivered to my parents.

With all of the groundwork for the project complete, I approached my brother and sister with my wonderful plan. Up until this point, I had not involved them in any of the preparation, so they had no idea what they were in for. It was at that moment that I learned something very important. Working by myself was easy. The hard part was engaging my sister and brother in the plan.

As I excitedly told them everything I had planned for the three of us, they did not seem especially thrilled with any of it, and they resisted my attempts to rehearse. After some unsuccessful attempts, however, I was able to entice them into participating. The price? I had to walk with them afterwards to the neighborhood store and buy them candy with my allowance. Having secured such a rewarding business deal, they were suddenly much more enthusiastic, and they put their heart and soul into the rehearsal. When we were finished, I fulfilled my end of the bargain. Maybe winning them over wasn’t so hard after all!

But on the night of the big performance, my sister dropped out. She claimed she was “sick”. To this day, I am not certain I believe that. Nonetheless, she sat in my mother’s lap the entire evening. I think she even fell asleep! Meanwhile, my brother participated but showed little enthusiasm for his role. I, on the other hand, delivered a stellar performance and ended with a rousing rendition of “Santa Claus is Coming to Town”.

Reflecting on this story many years later, I find amusement by the fact that it revealed several valuable lessons on leadership:

Anyone has the capacity to lead. You don’t have to have a impressive title to be “authorized” to take the lead in situations that need attention or resolution. For example, if there is equipment that is not working properly, you can take the lead to report it and follow through to make sure it is fixed. If there is a patient that needs assistance, even if you are not the nurse, patient care technician or medical assistant assigned to the patient, you can still make sure that person gets what he/she needs. In most cases, leadership is really local and informal.

Most acts of leadership require the engagement of others in the development of the plan, because you will need those individuals to execute the plan. I have often wondered what the outcome of my holiday production would have been if I had engaged my brother and sister in my plans. If I had involved them more, letting them help with the costumes, scenery and program, and if I had shown appreciation for their contributions, maybe they would have been more supportive and as excited as I was. Over the years, I have learned that the more leadership engages the individuals who are ultimately affected by a project during the planning process, the easier and more efficient the plan is to implement, and the stronger its end result. I believe this sort of inclusive thinking is important at UTMB, especially when projects impact our providers, clinicians and staff who work on the frontlines of patient care.

Informal leaders rely on open communication, a shared vision, and often, charisma. Looking back on this experience from my childhood, I now know that my plans were not openly communicated. There was no shared vision, and as far as charisma to motivate the group goes, I failed miserably in that department, too.

Informal leaders lead by example and through the strength of their character. In this instance, I wanted my brother and sister to enthusiastically perform, but the example with which I led was “I will develop the plans, and you will follow.” That is hardly a recipe for leadership success! Marshall Goldsmith, a noted speaker and writer on leadership who I also mentioned in last week’s report, reminds us that not only is it possible for leaders to sometimes add too much value, thus stifling group collaboration and creativity, but it is also important that they give everyone on the team a chance to stay informed of the plan’s status; otherwise, whatever is being planned is still only the leader’s vision, and those who are being asked to carry out the work may lose their enthusiasm.

Informal leaders are often more strongly committed to the group, because they are part of it on a daily basis. As formal leaders, we rely on informal leaders at all levels of the organization in order to effectively execute big plans and help achieve high-level goals. As informal leaders, we have a responsibility to our group to align our work in a way that supports and helps achieve those organizational goals. That is one reason why the Weekly Relay messages are so important—they create a forum that provides important organizational information to all employees and faculty, and they also encourage feedback from staff that should be relayed back to leadership. Two-way communication is a vital part of successfully carrying out plans.

This childhood experience taught me the five leadership lessons above. In my experience as a nine-year-old planning a big holiday production for my family, I had thought I was being a great leader; however, my brother and sister have always been quick to point out that I was simply “bossy”. Oh my, what an eye-opener!

John Quincy Adams once said, “If your actions inspire others to dream more, do more and become more, you are a leader.” As we go about our work, let’s be the best informal or formal leaders we can be so that we assure our patients and families always get the care and compassion they need. It is only through engaging everyone that UTMB can achieve the clearly articulated goals of the “The Road Ahead.”

President John F. Kennedy once said, “The time to repair the roof is when the sun is shining.”

It’s true—most of the time, we don’t go about our day with an expectation that an adverse event will occur. But unfortunately, sometimes there are emergency situations, whether or not we are prepared for them. And sometimes in health care, people make mistakes that result in patient harm, despite having the best intentions when caring for someone. This is why it is so important that at UTMB, we devote ourselves every day to promoting patient safety, environmental safety, proper patient identification, medication safety, infection control and effective communication, whatever our role may be.

For some time now, the Health System has been on high alert, busily preparing for our Joint Commission re-accreditation survey. However, the preparations and safety measures on which we are currently so acutely focused are things we should always be doing to ensure the safety of our patients and staff. Whether it is focusing on prevention, communication, processes, documentation, or ensuring pathways are clear in case of emergency, we must always be alert. Our re-accreditation survey window, which extends through the next two months, has been a great opportunity to reinvigorate our current efforts to ensure we are providing the safest possible care for our patients, families and one another.

Just as achieving high reliability in health care is a daily endeavor, our successful completion of the survey will require the cooperation and support of every provider and staff member. After the survey, our competitors, affiliates, managed care and insurance companies, referring physicians and, most impor­tantly, our patients and their families will be able to read the details of our performance. I believe the results they see will truly reflect that every UTMB faculty member, clinician and employee at every level is committed to providing excellent patient care!

Why is a good accreditation survey so important? The Joint Commission accreditation survey is a nationwide seal of approval indicating that UTMB meets high quality and safety perfor­mance standards. It says we deliver the best care to all of our patients in a safe environment. Therefore, we must remain committed to zero patient harm, a culture of safety, and continual process improvement. Never ignore or tolerate unsafe conditions, behaviors and practices, and when or if we see something that could be unsafe or cause harm, we must communicate clearly and close the loop on conversations with our team. If needed, escalate issues. It’s simply the right thing to do for our patients.

Our success on the survey will require everyone’s familiarity with Joint Commission requirements in their particular area, and I have full confidence in our teams that we will be fully prepared for the survey. Please review the materials provided on UTMB’s Joint Commission website, including readiness checklists and the preparedness handbook. If you are a manager or supervisor, review employee readiness tips with your team when you have your weekly relay meetings, especially handbook sections “How to Participate in the TJC Survey” and “Other Helpful Hints for the Survey” on pages 12-13.

Spanish novelist, poet and playwright Miguel de Cervantes once said, “To be prepared is half the victory.” Perhaps the other half is to remain vigilant!

There once was an executive named Joe, who worked for a medical device company. Joe was very worried about the device that he was working on. He thought that it was too complicated, and he thought that its complexity created margins of error that could really hurt patients.

He wanted to find a way to help, but when he looked around his organization, nobody else seemed to be at all worried. So, he didn’t really want to say anything. After all, maybe they knew something he didn’t. Maybe he’d look stupid. But he kept worrying about it, and he worried about it so much that he got to the point where he thought the only thing he could do was leave a job he loved.

In the end, however, Joe did find a way to raise his concerns. And what happened then is what almost always happens in this situation—it turned out everybody had exactly the same questions and doubts! So now Joe had allies, and everyone on his team was thinking about how to solve the problem together. And yes, there was debate and argument, but that allowed everyone around the table to be creative, to solve the problem, and to change the device.

By speaking up, Joe wasn’t undermining anyone’s work. In fact, he was improving the overall quality of the team’s work and protecting others from harm. Joe had always been passionately devoted to his organization and the higher purposes that the organization served, but he had always feared the conflict that would result from speaking up. When he did finally speak up, he discovered that he had not only contributed much more to the team than he had ever imagined, but his colleagues did not think negatively of him—they thought of him as a leader.

The story above was borrowed from a presentation by Margaret Heffernan, a writer and keynote speaker who frequently presents on how conflict avoidance and selective blindness can lead organizations astray. Fear of conflict is the very thing that leads to communication breakdowns and broken processes, which in turn, result in preventable errors.

We know from the premise of our Culture of Trust that significant safety failures are almost never caused by isolated errors committed by individuals. Rather, they result from multiple, smaller errors in environments with serious underlying system flaws. This is why regular feedback and communication is important.

A couple weeks ago, I shared a story about my own experiences with constructive feedback, and how at times, I have also found it uncomfortable to give and to receive. However, I realize the importance of constructive conversations, and even though they may involve a difference of opinion, they are a very necessary part of conducting safe, effective and successful work for several good reasons:

We don’t always have an internal cue that lets us know that we’re wrong about something until it’s too late.

Without a shared understanding of people’s points of view when it comes to concerns, people might blame problems on other people, and not where it actually should be, like broken or inefficient processes.

Continual two-way feedback allows people to focus on one or two areas for improvement, rather than having to address a much larger problem that has already caused harm or will require significant intervention and time to resolve.

If we truly care about providing the safest care for our patients, we will be committed to speaking up. Continual quality and safety improvement is the right thing to do. As we observed in Joe’s case, speaking up helped the team and the individual to achieve success. That is why we have to be willing to listen to and consider what others are saying to us. Individually, we must keep an open mind and be willing to work through problems strategically. As a team, we know this is important because it will ultimately help us succeed. Unless we think together, we will fail to get the best out of one another!

Whether we have a gut feeling about the condition or functionality of a device, or we feel concerned that a care process may be unsafe, we need to act with safety in mind and speak up. In health care, we are accountable for our own actions and for those of our team. As we go about our important work, let’s be conscious of any system design that may potentially cause harm if we do not identify the flaws and fix them before a patient is affected. Instead of being afraid of conflict, we have to address the issues head-on.

My job is to make sure that you have what you need to be able to take care of our patients. If you don’t, my hope is that you will make your manager aware, and if you are the manager and you cannot get what you need to ensure your team can provide the right care at the right time in the right way for your patients, you will continue to escalate the matter, without fear of consequence, until you get a resolution. This does not mean that the decision will always be exactly what you want or asked for, but you should receive an answer and a resolution that leaves you with a sense of closure.

Remember: “You can blame people who knock things over in the dark or you can begin to light candles. You’re only at fault if you know about the problem and choose to do nothing.” – Paul Hawken

“Whatever you or the public may consider quality to be, this definition is always a safe guide to follow: Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skillful execution; it represents the wise choice of many alternatives.” ~Will A. Foster

Each New Year is a chance to commit to what we hope to achieve in the future. Last week, we established four areas in which we will focus to be successful this year: continued investments in our people, quantum leaps in quality and safety, transparency with our outcomes, and the wise use of our resources. In this first Friday Flash message of FY16, I’d like to explore our focus on quality.

Quality is defined as the standard of something measured against other things of a similar kind—the degree of excellence of something. It can mean everything from caliber or condition, character or worth, and it can be good or poor. Defining health care quality, however, is a little more technical. In fact, if you conduct an internet search for the words “health care quality” you’ll find a long list of organizations working to promote health care quality in hospitals, and you’ll also see numerous guides on how to improve in areas like patient outcomes, 30-day readmissions, and healthcare-associated infections. You may even find an infographic or two on reimbursement calculations!

To make a long story short, much of what is out there is written by the health care industry for the health care industry—and it is complex! As an industry, we even have had to find a way to state it simply to steady our focus. The Agency for Healthcare Research and Quality (AHRQ), the federal government’s leading agency, defines quality health care as “doing the right thing for the right patient, at the right time, in the right way to achieve the best possible results.”

But what do our patients and their families think “quality” health care means, and what do they expect of us when we say that we are committed to quality? Several years ago, in an issue of the Journal of the American Medical Association (JAMA), Dr. Allan Detsky, an internist and health policy expert at the University of Toronto, identified criteria that patients expect when asked what they really want from health care.

He found, as one would expect, that patients want the best health care—they want to know that their care team is highly qualified and experienced, and they want to know the care they will receive is reliable, based on feedback from people they know, a referring physician, or other patients. This is not to say that patients don’t value statistics—our quality performance is currently publicly reported, so patients can compare us against other providers and know whether or not we are an excellent place to come for health care. It’s simply that they are more focused on whether the treatments they will receive will work in their specific case or condition.

The list of criteria is long, but the following are the most important aspects of care patients identified:

Timeliness. Patients desire access to services in a timely fashion.

Kindness. Patients want to be treated with kindness, empathy, and with respect for their privacy.

Hope and certainty. Even in dire situations, patients want to have hope and be offered options that may help. Patients and families are uncomfortable with uncertainty about diagnoses and prognoses. Therefore, they want to feel well informed, participate in decision making, and prefer active strategies.

Continuity, choice, coordination. Patients want continuity of care and choice. They want to build a relationship with a health care professional or team in whom they have confidence and have that same person or team care for them in each episode of a similar illness. They want the members of their health care team to communicate with each other to coordinate their care.

Privacy. Patients want to be hospitalized in their own room with their own bathroom and no roommate (this is something we proudly offer our patients at UTMB).

Low out-of-pocket costs. Patients want to pay as little as possible from their own pocket at the point of service delivery.

Medications and surgery. Patients prefer treatments that they perceive will require little effort on their part. Essentially, they want to feel “well taken care of”.

There is a much more important, patient-focused reason for making quality improvements: it’s the right thing to do. When we safely heal people and they have a positive experience in our care, they are more likely to follow through with their doctor’s advice and manage their disease processes, which leads to better patient outcomes and healthier patients in the future.

So, let’s focus on our patients’ experiences, with the understanding that they already trust us to do the right thing by delivering safe, evidence-based care and they trust us to monitor our own performance, much in the same way that we all trust airlines to make sure the plane is functioning well before takeoff!

Every individual in every role at UTMB impacts the patient experience in one way or another. This is why we must all focus on making the necessary changes to create a culture in which excellence can flourish. Whatever our work entails, we should reflect on the following:

Do we work together as a team, and are we committed to a culture of trust and safety, in which we can express our thoughts and concerns and constructively think together?

Do we demonstrate integrity by always doing the right thing for our patients and their families?

Do we show compassion and respect to all, so we not only work well together, but so that we are able to comfort patients and families during challenging times, or support them so they are motivated to heal? Do we promptly respond to patient and family concerns, whether by phone or the call button? Are we willing to take the time to explain things clearly and answer all of their questions?

Do we value diversity so that we can understand patients’ perspectives and preferences and fully engage them and their families in making decisions about their care and treatment?

Are we committed to lifelong learning, so that we are able to apply new knowledge and always explore better ways to enhance outcomes while remaining vigilant to assure patients’ safety?

If we are firmly committed to quality, and we practice safety measures the same way, every patient, every time, we will not only improve our performance, but we will be better able to focus on the experience of our patients and their families. At UTMB, we should always be able to look people directly in the eye and say: “The care you will receive at UTMB Health will be the same care I would want my most cherished of loved ones to receive.”